Pancreatic cancer rates are rising among Americans, with the sharpest increases in younger women, a new study finds.

The new nationwide analysis of nearly two decades of data revealed that rates in women below 55 rose 2.4% more than in their male counterparts. Young Black women, in particular, saw their rates increase 2.23% more than those in Black men the same age, researchers reported in Gastroenterology.

While pancreatic cancer is still more common among men, “over the last 20 years the risk has been rising in women, and if this continues, over time, it will be more common in women,” study co-author Dr. Srinivas Gaddam, head of the pancreatic screening and early detection program at Cedars-Sinai Cancer Center in Los Angeles, tells TODAY.com. “This calls attention to the need for investing more research dollars into why this is happening and how we can avert it.”

Pancreatic cancer is the 10th most common cancer, but it’s the third most deadly cancer, Gaddam says. “It’s rare, but when it occurs, it takes life very quickly.”

One reason pancreatic cancer is so deadly is that it is most often detected at a late stage, Gaddam says. He adds that warning signs and symptoms are rare and that abdominal pain rarely occurs as a result of pancreatic cancer.

While 42% of patients diagnosed with an early stage tumor survive at least five years, just 3% of those with metastatic disease, where the cancer has spread to other parts of the body, survive at least five years, according to the American Cancer Society.

To take a closer look at trends in pancreatic cancer, Gaddam and his colleagues turned to data from the National Program of Cancer Registries, which represents 64.5% of the U.S. population. Combing through the data, the researchers identified 454,611 patients diagnosed between 2001 and 2018.

Rates of the cancer increased among both men and women during those nearly two decades, but they rose more in women, especially women under age 55. In more bad news for women, Gaddam notes that survival had improved each year in men but not in women.

The new study’s findings are “provocative, but not completely surprising,” Dr. Diane Simeone, director of the Pancreatic Cancer Center at NYU Langone Health in New York City, tells TODAY.com. “There needs to be more focus on understanding the risk factors and developing early detection strategies for this disease.”

Until a good screening test is developed, there are strategies to detect pancreatic cancer early, Simeone says. First, because more than a dozen genetic mutations that increase the risk of the cancer have been discovered, people with a family history of the disease should be checked for those mutations.

Moreover, certain factors, including smoking, heavy drinking, obesity and diabetes, can raise the risk of pancreatic cancer, Simeone says. People who appear to be at a higher risk can be checked with MRI or endoscopic ultrasound.

The trend of rising rates of early onset cancer is important, “and it’s not just pancreatic cancer,” Dr. Fay Kastrinos, director of the Muzzi Mirza Pancreatic Cancer Prevention and Genetics Program at the Columbia University Irving Medical Center in New York City, tells TODAY.com.

Still, Kastrinos says, while there are increasing rates in women, the number of patients is small, overall. “So we don’t want alarms going off,” Kastrinos adds. “But the trend is important.”

Future research will need to grapple with a specific question: What is it about women that is causing this increase? “Is it a sex-specific factor?” Kastrinos says. “There could be environmental exposures and hazards, and whenever there are early onset cancers, we need to look at genetics.”

Dr. Suneel Kamath was also struck by the increase in early onset disease.

“What’s most concerning are the pancreatic cancers in very young people, those in their teens, twenties and thirties,” Kamath, a gastrointestinal medical oncologist at the Cleveland Clinic, tells TODAY.com. “They are largely unexplained.”

Right now, we don’t know what is driving the increases in pancreatic cancer, Kamath says. “There are a lot of theories,” she adds. “Diet may be a big part of it. There’s been a big increase in the consumption of processed foods and red meat, and people are eating less leafy green vegetables.”

Americans are also more sedentary than they used to be and that may contribute to cancer risk, Kamath says.

Another possible cause could be antibiotic use. “This generation is much more exposed to antibiotics,” Kamath adds. “Every cold led to a prescription for antibiotics when most were viruses. That can impact the microbiome, which can affect a lot of things.”

Another possible explanation could be the skyrocketing numbers of Americans who are overweight or obese, including younger and younger kids, Kamath says. “It tracks with this trend in pancreatic cancer,” she adds. “The more years you are at an unhealthy weight may also factor in.”

This article was originally published on TODAY.com